Reconfiguring acute hospitals in England: Clinicians are fatigued by health policy and policy makers

doi:10.1136/bmj.39058.701065.3A

BMJ 2006;333:1271 (16 December), doi:10.1136/bmj.39058.701065.3A

Letters

Reconfiguring acute hospitals in England

Clinicians are fatigued by health policy and policy makers

The first 150 words of the full text of this article appear below.

Transferring "less sick" people into non-acutehospital settings doesn't necessarily save money.¹ At least15 schemes, vigorously supported and in some cases piloted byour acute hospital, have been rejected or discontinued by theprimary care trust on financial grounds. The University of Birminghamhas reviewed the evidence for the cost effectiveness of movingless sick patients into non-hospital settings and concludesthat these changes will not automatically reduce costs.² Sadlythis document also concludes that there is little evidence thatthis health policy will reduce reliance on acute hospital care,despite the premise that there is a reduced need for acute hospitalbeds.

We agree with Ham that the NHS should make itclear why change is needed and articulate a persuasive and reasonedcase to support proposals that are bound to be controversial.¹What we don't need are further eloquent health policy editorialsand overviews to "clarify." As . . . [Full text of this article]

Richard Venn, consultant in intensive care , Lui G Forni, consultant inrenal medicine and intensive care

¹ Worthing Hospital, Worthing, West Sussex BN11 2DH

richard.venn@wash.nhs.uk